Myopia and refractive changes lead to visual impairment, lens power changes, and blindness. The vision examinations are conducted to identify disorders and treat them. This study aims to assess the progress and evaluate the risk factors of myopic incidence and refractive changes.

The Chinese study enrolled a total of 601 rural children who completed baseline and follow-up examinations. Both cycloplegic and non-cycloplegic autorefraction was measured with a mean follow-up period of 40.93 to 43.87 months.

The axial length and cumulative refractive changes were 0.39±0.46 mm and −0.53±1.03 diopter, respectively. 105 out of 469 non-myopic baseline children were myopic at the follow-up. The annual myopia incidence was 6.3%, with a cumulative incidence of 22.4%. The rapid refractive change was associated after adjustments with younger age, higher baseline, and paternal refraction. Large cycloplegic and non-cycloplegic refraction differences also played a significant role in causing the rapid myopic refractive change. Myopic incidence was also related to higher baseline relative risk refraction, and myopic paternal refraction.

The cohort study found relatively low myopic incidence and refractive change. Both paternal and children’s refraction were associated with them. More research will exemplify the rural-urban children’s’ visual acuity differences. Further comparative studies are required to understand the Chinese and global patterns.